Is It Better to Get a Given Amount of Covid Over With More Quickly?

The Delta variant has caused infections to surge in multiple countries, and is even driving up hospitalisations in some U.S. states, notably Florida. (Although that state has a vaccination rate only 10 percentage points lower than the U.K., vaccinations are not as concentrated among the elderly as they are here.)

What should we make of the surge of infections, and indeed hospitalisations, caused by the Delta variant? In a recent blog post, the economist Tyler Cowen argues that things aren’t quite as simple as many people – or at least many lockdown proponents – are assuming.

Cowen notes, “Even the growth of hospitalisations, much less the growth in cases, is a misleading signal for how well we are doing.” Why is that? As Cowen argues, “it is better to get a given amount of Covid over with more quickly rather than less quickly … subject to the constraint that you do not overwhelm your hospital system.”

All else being equal, the faster Covid spreads among people who do not yet have immunity (either from vaccination or natural infection), the shorter the time for which the healthcare system is under stress, and the faster immunity builds up in the population as a whole. Assuming, that is, your hospitals aren’t overwhelmed.

Interestingly, Cowen’s argument is not dissimilar to the Great Barrington Declaration. That document notes: “As immunity builds in the population, the risk of infection to all – including the vulnerable – falls.” And we should therefore allow “those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection”.

I say “interestingly” because Cowen previously criticised the Declaration, claiming that it “strikes exactly the wrong tone and stresses exactly the wrong points”. However, he would presumably say the situation is different now (we have vaccines), and letting the virus spread among people who are voluntarily unvaccinated is not the same as letting it spread among people who haven’t yet been offered a vaccine.

I still maintain that focused protection trumps lockdown regardless of whether a vaccine is available, given the limited efficacy and substantial harms of lockdown. But it’s good to see Cowen acknowledge the case for building up immunity more quickly.

His observations raise the question of whether Western countries should have encouraged young people to gain immunity through natural infection in the spring/summer of 2020 (or at the very least not discouraged them through protracted lockdowns). If we’d taken a more relaxed approach then, we might have been in a better position entering the winter of 2020.

Lockdown sceptics will find several things to disagree with in Cowen’s blog post, but it’s still worth reading in full.